American Medical Association Family Medical Guide - American Medical Association [744]
If not treated, this process continues until more and more of the retina lifts away from the choroid. Eventually, the retina is attached only at the front of the eye (to the ciliary body) and at the back of the eye (to the end of the optic nerve). Retinal detachment may affect both eyes, but rarely at the same time.
Retinal detachment is a rare condition, affecting middle-aged and older men and women in equal numbers. People who are nearsighted (see page 1030) have an increased risk of retinal detachment because the retina is stretched abnormally by the elongated shape of the eyeball. Other risk factors include eye injury and having a lens removed for treatment of a cataract (see page 1041). If the disorder is left untreated, a person can lose vision in the affected eye.
Symptoms
The early symptoms of retinal detachment include flashes of light and tiny spots and specks called floaters that drift across the visual field. As the condition progresses, you may lose part of your peripheral (side) vision in the affected eye, a symptom that often resembles a narrow purple or black curtain coming from the top, bottom, or side of the affected eye. If the detachment is not treated, more of the visual field is lost and the vision that remains becomes progressively blurred.
Diagnosis
A diagnosis of retinal detachment is based on the symptoms and an eye examination. The ophthalmologist dilates (widens) your pupils with eyedrops and then examines your retinas while looking through an ophthalmoscope (a viewing instrument that projects a bright light onto the back of the eye). He or she also tests your peripheral vision.
Treatment
If an ophthalmologist detects a hole or tear in the retina before detachment begins, he or she may repair the tissue using either cryosurgery (freezing) or laser photocoagulation (in which a highly concentrated beam of light is used to seal or destroy the area around the tear). Both treatments are used to secure the retina to the eye and can be performed using either a sedative or a local anesthetic in a doctor’s office or in an outpatient facility.
If detachment has already begun, an ophthalmologist may recommend a surgical procedure called scleral buckling, in which the fluid between the retina and choroid is drained to allow the retina to fall back into place against the choroid. The hole or tear in the retina is then sealed and a silicone band is sewn around the eye to securely attach the sclera (the white of the eye) to the retina.
In a procedure called pneumatic retinopexy, the doctor injects a small gas bubble into the vitreous fluid to push the retina back against the choroid. These procedures may be done either in a hospital or in an outpatient facility using either local or general anesthesia.
Your vision will probably return to normal if the procedure is performed before detachment has begun or if the detachment is limited to the front edge of the retina. If the detachment is more extensive and your central vision has been affected, your visual field and central vision may be permanently impaired to some extent.
After retinal detachment in one eye, there is a significant risk that the condition will develop in the other eye. For this reason, you should see your ophthalmologist as often as he or she recommends to watch for any weak areas in the retina.
Retinal detachment
Retinal detachment occurs when a hole or tear in the retina allows vitreous fluid to seep between the choroid and the retina, causing the retina to lift away from the choroid, impairing vision.
Retinal Artery Occlusion
The retina (the light-sensitive membrane lining the back of the eye) receives its blood supply from the central retinal artery, a tiny blood vessel that enters the back of the eye through the optic nerve. Sometimes,